*How many dependents (i.e., children under age 18, disabled adults, or full-time students (other than head or spouse) will live with you?

*Are you or your spouse at least 62 years old, or disabled?(Please answer Y or N)

YesNo

*Are you working, looking for work, or in school?(Please answer Y or N)

YesNo

This is your estimated adjusted annual income

This is your estimated monthly income-based rent

NOTE: Families can select to pay a flat rent, which is based on the number of bedrooms.Below is DHC’s current flat rent schedule:

Estimated Monthly Income-Based Flat Rent

# of bedrooms

1 bedroom

2 bedrooms

3 bedrooms

4 bedrooms

5 bedrooms

6 bedrooms

Flat Rent

686

829

986

1017

1022

1156

NOTE: This information is only an estimate of possible eligibility and rent.
Families admitted to DHC’s Low Income Public Housing Program must first apply for housing and subsequently meet both
eligibility and suitability criteria before an offer of housing is made. Information provided by families must be verified by DHC.
This estimate is not a guarantee of income eligibility, should not be considered an offer of housing by DHC,
whether implied or expressed, nor does it obligate the DHC in any manner to offer housing to your family.